Active NPI
David Brent Moore, MSCCC/SLP BCHIS
- Speech-Language Pathologist
- Chickasha, OK
National Provider Identifier
1053975979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2184
- Practice address
- 2201 W Iowa Ave Ste 5
Chickasha, OK 73018-2732 - Phone
- (405) 222-4444
- Fax
- (405) 222-4402
- NPI assigned
- Apr 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2184 | OK | Primary |
Addresses
Primary practice location
2201 W Iowa Ave Ste 5
Chickasha, OK 73018-2732
Mailing address
2201 W Iowa Ave Ste 5
Chickasha, OK 73018-2732
Phone (405) 222-4444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2184 | OK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasha Hearing Aid Center | Single Specialty | Past | Accepting new patients |
| Ortega Operations, LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hearing Instrument Specialist
- Chickasha, OK
- NPI 1578767307
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1053975979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 W IOWA AVE STE 5",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730182732",
"telephone_number": "405-222-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 W IOWA AVE STE 5",
"city": "CHICKASHA",
"state": "OK",
"postal_code": "730182732",
"telephone_number": "405-222-4444",
"fax_number": "405-222-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DAVID",
"middle_name": "BRENT",
"credential": "MSCCC/SLP BCHIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-25",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chickasha, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.